<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN"
"http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
	<head>
		<meta http-equiv="Content-type" content="text/html;charset=UTF-8" />
		<title>Test</title>
		<style type="text/css">			
			fieldset
			{
				border: solid 1px #d5d5d5;
				background-color: #e9e8e3;
				margin-top: 12px;
			}
			ol
			{
				list-style-type: none;
			}
			li
			{
				display: block;
			}
			label
			{
				display: block;
				margin-top: 12px;
			}
			input[type=text]
			{
				font-family: Verdana,Sans-serif;
				size: 8pt;
				border: solid 1px #d5d5d5;				
			}
		</style>
	</head>	
	<body>
		<fieldset>
			<legend>General Information</legend>
			<ol>
				<li>
					<label for="firstName">First Name</label>
					<input id="firstName" name="firstName" type="text" />
					<label for="lastName">Last Name</label>
					<input id="lastName" name="lastName" type="text" />
				</li>
				<li>
					<label for="address">Address</label>
					<input id="address" name="address" type="text" />
				</li>
				<li>
					<label for="state">State</label>
					<input id="state" name="state" type="text" />
					<label for="city">City</label>
					<input id="city" name="city" type="text" />
					<label for="zip">Zip</label>
					<input id="zip" name="zip" type="text" />
				</li>
			</ol>
		</fieldset>			
	</body>
</html>